After Giving Birth To a Cesarean Baby

Ideally during a Cesarean delivery, a pediatrician is present or nearby and readily available should any problems or complications arise.

In a Cesarean, as in a vaginal delivery, the baby may be born head first or breech first. As soon as the head is delivered, mucus will be suctioned out of the nose and mouth to allow a clear passageway for breathing. When the entire body is born and if the umbilical cord is long enough, the obstetrician may hold the baby up high enough for you to see over the screen that covers your chest. If the baby's father is present for the delivery, he will have about the same span of vision from his seat on a stool alongside you. His head will be approximately level with yours and his view of the surgical area will be hampered by your chest screen.

At first sight your baby will be wet, possibly a bit bloody, perhaps covered with some vernix, and the skin may be bluish.

After the cord is clamped and cut, the baby will probably be handed to a pediatrician or nurse, who then carries him or her to another area of the delivery room where he or she is further attended to.

The baby will probably be placed in a special unit, which will regulate body temperature, has equipment for sucking out more secretions from the mouth, nose, and throat, and has oxygen available in case it is needed. The pediatrician will examine the baby to be sure all vital signs are good and that there are no serious problems. This may take approximately three to five minutes.

After the baby has been examined, suctioned, and judged to be out of danger, he or she will be wrapped and may be brought to you while you are still on the delivery table and the obstetrician is tending to your abdomen. If the father is present, he can hold and bring the baby to you. If your arms are not free, the baby can be held - by the father or nurse - close to your face for you to look at, kiss, and touch with your cheek. If one arm can be freed (which usually can be arranged), perhaps the baby can be placed on your chest for you to hold with your free arm.

After the usual delivery room procedures and, possibly, some time spent with the parents, the Cesarean-born infant is - in most cases - routinely whisked away to the nursery for special observation and care and is kept there for an eight- to twenty-four-hour period.

The rationale for this is that Cesarean babies tend to have more mucus and respiratory problems than those born vaginally and they therefore need closer observation.


However, if there is no indication of respiratory difficulty and no medical reason for the baby to be kept under special care in the nursery (other than routine observation) and if you would like to hold and get to know your baby for a while, express your wishes. Many health care professionals see no reason against this and every reason to encourage early bonding, which can take place in the delivery or recovery room. More and more hospitals today are beginning to relax their previous inflexible rules and are treating each Cesarean baby according to the infant's individual condition and birth circumstances, instead of using one ruling for all.

If your baby is kept under special care for observation (not treatment) he or she will probably be in a warmer (heated crib) to stabilize the body temperature. If the baby is premature, weighs under five pounds, or has any respiratory or other problems, he or she will be in a special enclosed unit, which regulates temperature and provides a sterile atmosphere. In more and more hospitals today, under certain circumstances, the new mother can come to the nursery and touch, caress, and sometimes feed her infant through the special openings (portholes) in the enclosed unit. The Cesarean baby who has been separated from his or her mother for many hours or several days needs extra cuddling and loving.

Possible Problems Of The Cesarean Newborn

1. Because Cesarean babies do not pass through the vaginal canal, they do not benefit from the “big squeeze” which the narrow passageway would ordinarily give to the lungs. As a result, they are born with more fluid in the lungs and may have more difficulty breathing and clearing the respiratory passages.

2. Just as fluids are squeezed out of vaginally delivered babies' lungs, so gastric substances are squeezed out of their stomachs. Not having benefited from this pressure, Cesarean infants tend to be more “mucusy.”

3. Many premature labors result in Cesarean deliveries and these premature babies tend to develop what is called a “hyaline membrane” in their lungs; this interferes with breathing. Hyaline membrane disease is often mistakenly thought to be the result of Cesarean birth. The cause seems to be related to the immaturity of the infant's lungs, not to the method of delivery - and this cannot be helped if labor begins and the baby is born before being mature enough. However, when a Cesarean delivery is planned in advance (i.e., a repeat Cesarean or one necessitated by an inadequate pelvis), precautions can be taken to prevent the possibility of delivering a prematurely developed infant. This is done with the aid of amniocentesis or sonography. When fetal maturity is thereby confirmed, a date can more safely be chosen for scheduling the Cesarean.

Feelings After A Cesarean

One of the most difficult aspects of a Cesarean delivery is coming to terms with the fact afterward. No matter how advanced the technology, no matter how common the procedure - major abdominal surgery did occur and the early days of recuperation are extremely difficult.

If your Cesarean was performed under emergency conditions and you were awake at the time the decision was made, you may be able to readily accept the reality of what has happened. If your baby had been in danger and the most feasible way to accomplish a safe delivery was by surgery, you may very likely feel thankful that Cesarean delivery was a safe alternative, and feel relief that the danger has passed and joy at the sight of a healthy baby.

One woman reported, “When they said 'fetal distress' and started rushing around and someone tried to calm me by saying 'everything will be all right,' I knew that everything might not be all right and after the Cesarean all I could think was 'Thank goodness the baby's all right.' If they had waited or if this had been a century ago, I would not have my beautiful and healthy baby.”

If you had had a long, painful labor, you may feel a great sense of relief that it's all over and be grateful for the end of your suffering - thanks to a Cesarean delivery. Another woman had this to say: “I never thought I could actually welcome the idea of a Cesarean, but by the time the doctor decided to go ahead with surgery, I was the happiest woman in the world. I had been in hard labor for many hours and this meant that it would soon be all over.”

It is quite possible that you have accepted your surgery as a matter of necessity, fully understanding the circumstances surrounding it, and are not upset that it has occurred. Some Cesarean mothers do express feelings of being glad labor is over, that they and the baby are healthy - and who cares about the scar as long as everything is all right?

Sometimes, however, negative thoughts and feelings about the experience may be blocked temporarily and can surface the next day, or weeks or months later when a related incident can open the floodgates. A simple statement from a new mother you meet at your childbirth preparation class reunion (“Lamaze is the only way to have a baby!”) or a question from another mother at the pediatrician's office (“Did you go natural?”) can set you off. After a Cesarean delivery, many new mothers do not easily accept what happened. In re-living the events in your head, you may begin to feel that the hours of labor and discomfort prior to surgery were all in vain. You may begin to resent your doctor for allowing the labor to go on for so long before deciding on the Cesarean. Or, if the decision to do it was made early in labor, you might now be questioning the motives and silently accusing the doctor of being “knife happy,” “planning all along to do a Cesarean,” or “in too much of a hurry” to give you “more of a chance to get that baby down” yourself.

No matter what the circumstances were at the moment of decision - whether it was an emergency or not, whether you had been prepared in advance for the possibility of surgery or not - you may now have a very-strong need to understand exactly what happened. It may become vital for you to reconstruct the events - one by one - leading up to and culminating in the doctor's decision to operate. No matter how much your doctor may have been able to explain prior to surgery (if you were awake), no matter how well you were able to understand the reasoning at the time, you, the Cesarean mother, need to and deserve to hear it all again. You may hear yourself asking question after question, repeating yourself many times to several different people - the doctor, the nurses, your mate, anyone who knows something about your experience - because you, just like the vaginally delivered mother, need to fit together the missing pieces of your experience. In fact, this is probably even more important to you than to a vaginally delivered mother because you have the additional need to justify in your own mind the way your baby was born.

Even after receiving all the information and reassurance you can get, you still may feel disappointment in the way things turned out.


If you had hoped to have a Lamaze or other such prepared delivery, your feelings may range from disappointment and frustration to anger and resentment for not having “given birth.” The baby was “taken” from you by a relative stranger: the doctor.

Some Cesarean mothers who had counted on a vaginal delivery may feel “abnormal” because they did not have what is considered a “normal” delivery. Thoughts like “What's wrong with me? Why couldn't I have my baby the right way? I'm not a real woman, I'm just not made right” are common.

A sense of failure is also common. “I couldn't do it. Not only couldn't I have the Lamaze delivery I planned and practiced for, but I couldn't even have a run-of-the-mill; old-fashioned vaginal delivery, Lamaze or not!”

Another feeling often expressed is that of being “cheated” out of the birth experience because you didn't “push the baby out.” If you were asleep for the Cesarean, you might feel this even more acutely because your active participation - even as observer - was removed by general anesthesia.

“I'll never know what it feels like to give birth, to push a baby out - like other women.”

There are other women, to be sure, who would prefer not to feel the feelings Cesarean mothers miss.

If you had planned to share your birth experience with your mate after having gone together to childbirth preparation classes, practiced the exercises, and looked forward to being together for a most important moment in your lives, your disappointments are greater if the father is excluded. You may feel guilty for “letting him down” and preventing him from being present at his child's birth. More self-blame.

Besides feeling bad for your mate, it is likely that you felt as bad or worse about being “alone” for the delivery. One of the most commonly expressed regrets of Cesarean mothers is that of being separated from their mates at the most stressful time - going into the operating room. A feeling of abandonment is common.

“I felt lost, alone, on my own at a time I desperately needed not to be.”

“How could they send Gary away when they saw the difference in me? I was so calm and in control and able to handle the whole thing. But as soon as the doctor told him he had to go, I panicked! But they didn't care. All they cared about were the rules.”

Your disappointment may lead to feelings of resentment. You may even become angry - at the doctor, your childbirth preparation instructor, the baby, or even the baby's father - for their parts in the eventual outcome. The doctor, for the decision to operate; your instructor, for not having prepared you for this; the baby, for making labor difficult and vaginal delivery impossible; and the baby's father, for starting it all at conception. If you decide it is unreasonable to direct your anger toward others, you may find it more acceptable to become angry with yourself, Why not? you may reason. Somebody's got to be at fault.

You may find yourself falling into the “if only” syndrome: if only I had been able to hold out longer, if only I had practiced my breathing more, if only I had pushed better, if only I was more relaxed, if only I wasn't so uncooperative I wouldn't have needed a Cesarean.

If you are thinking along these lines, it bears some re-thinking: can you really blame yourself if your baby was too large for your pelvis, if your pelvis was too small for your baby, if your baby's position made it impossible to be born vaginally, if your cervix refused to dilate enough, etc., etc., etc.!?? Logically, no. Therefore, try to catch yourself each time you think self-blaming thoughts and redirect them to what really happened. You do not have control over the size of your pelvis, a transverse position, a stubborn cervix, etc..

Your feelings from day to day may change drastically. One day you may be so happy that all is well with you and your baby and not care that yours was a Cesarean delivery; the next day you might be very upset and angry that this had to happen to you. Strangely conflicting and shifting emotions may plague you from day to day because you are experiencing normal postpartum hormonal changes and you are recuperating from the shock of a major abdominal operation. In addition, it is possible that medication you may be receiving for pain relief might be having a depressing effect on you. You might want to discuss this with your doctor.

If you were asleep for the delivery - especially if you had not planned it that way - it may be very difficult for you, the Cesarean mother, to make the connection between the baby handed to you in a neatly wrapped bundle twenty-four hours after birth and the baby that had been within your body before surgery. There was a time lapse, a missing segment which has to be accounted for and adjusted to. Even if you had been awake and the baby was shown to you briefly in the operating room, before being whisked away to the nursery for twenty-four hours, identifying with the baby is sometimes difficult. Mothers who were awake during a Cesarean delivery describe feelings of being “removed” from the birth process because of the screen placed on their chests. The purpose of the screen is to block the possibility of infection from entering the sterile field. However, it also blocks the sight and awareness of the abdominal area.

“My head seemed to be a separate part of me - totally removed from the rest of my body. It was almost like being the showgirl who gets cut in half in a magic show. That's how I felt. The part of me that had the baby was so far away that it wasn't real, it couldn't be happening!”

Concern about the baby's welfare is often aggravated by routine nursing procedures:

“After the cord was cut they took the baby to the other side of the room where I couldn't see him at all. Then, without more than a glimpse of him, they had him out of the room and to the nursery.”

These feelings point up the need for change in hospital routines to help Cesarean mothers “connect” with their babies. Some hospitals have begun to show sensitivity to these needs by examining the newborn within the mother's line of vision if she is awake so she can see her new baby as he or she is being examined and suctioned. If no special care is required, the new father can hold the baby and place the baby close to the mother's face for kissing and cuddling.

One or both of the mother's hands can be freed of restraint so she can touch and fondle her infant. The baby might also be placed on her shoulder.

Because most hospitals routinely place Cesarean babies under special care, you might be separated from your baby for twelve to twenty-four hours. This may give you the feeling that your baby belongs to everyone else at the hospital but you. More isolation. More feelings of being different from other mothers who can have and hold their babies. However, more and more hospitals are relaxing their routine rules about separating mother and baby and deciding procedure according to the baby's condition. And, through mounting consumer pressure, individually and from Cesarean support groups, hospitals are beginning to recognize and meet the special needs of Cesarean parents.

Many Cesarean mothers who breastfeed their babies say that this was the saving grace for them because in no other way did they feel “normal.” “At least I could do something right.”

If you are having difficulty getting started with breastfeeding, get all the help and encouragement you can from other breastfeeding mothers in order to help you through the first few weeks which are usually the most difficult. Without such help you might be tempted to give up before giving it a good enough try and consider it yet another “failure.” The Postpartum period is shaky enough under ordinary circumstances, and you, more than the vaginally delivered new mother, need every boost you can get to enhance your self-esteem.

To compound your feelings of inadequacy, you may hear yourself referred to as “the section in Room 211.” Resentment has been so strong among today's Cesarean mothers because of the routine use of the word section that Cesarean support groups throughout the country have latched onto the battle cry: “Grapefruits are sectioned; women give birth!” This clearly expresses the sentiments of Cesarean mothers and has helped to raise the consciousness of a growing number of childbirth educators who studiously avoid using section in classes and speak instead of “Cesarean birth,” “Cesarean baby,” or simply “a Cesarean.” The next step is to raise the consciousness of our medical and nursing school educators so that each new crop of aspiring doctors and nurses will stop referring to Cesarean mothers as “sections.“

You, the new mother who happened to have your baby by Cesarean, are nevertheless a new mother. You have had a baby and need to be treated not just as a surgical patient - which undeniably you are - but also, and very importantly as the new mother you are.

You need to know and accept the fact that it really does not matter through which route your baby managed to enter our world (as long as it was the route of necessity). Try putting the mode of delivery in perspective: It was not your prime reason for conceiving. This thought may help you to come to terms with what happened. It may also help if you look at yourself in terms of a total person does the childbirth delivery route many way affect the person you are? Does it make you less of a mother, lover, friend, neighbor, whatever?

Crying jags and depression may occur more so to you, the Cesarean mother, because there are more frustrati.ons. While the vaginally delivered mother in the next bed is up and around on the first day, your slightest movement - turning over, sitting up, coughing - takes enormous effort and hurts for several days. While she is heartily indulging in all kinds of goodies from her hospital food trays and snacks from visitors, your daily fare three times a day the first few days (if your doctor is of the soft-foods-after-Cesarean school of thought) is gelatin or custard, clear broth, and tea.


While she may be re-telling her Lamaze birth experience for the umpteenth time, you may be explaining to friends why your Cesarean was necessary. While she's packing to leave for home with her new baby, you're still learning how to “splint your incision” and “stand up straight, honey.” And on the day you may have bid farewell and good luck to another roommate who has come and gone before you, a flood of tears can easily be triggered at the sight of yet another tray of food with the inevitable gelatin.

If you have other children at home, and your hospital does not permit sibling visitation, you have yet another frustration to contend with: the lack of contact (other than by telephone) with your children for an extended period. This can be difficult for the children to handle because not only will they have to deal with a new baby in their midst, but they may find it hard to comprehend why their mother had to be away from home and in a hospital which was off-limits to them - with that new baby! Your frustrations resulting from this situation are not helpful to your recuperation. After such an experience, many new mothers - Cesarean or not - seek out a hospital for the next time which permits sibling visitation, or they join organizations which work to change existing hospital policies.

Since Cesarean mothers as a group tend to include a higher than usual number of women with high-risk tendencies (due to diabetes or other problems), their babies often are placed in special care units. Knowing your baby is being specially cared for and observed adds to the usual concerns many new mothers have about the welfare of their babies. Mixed with your worry about the baby's condition may be a sense of relief that “someone else is taking care of the baby,” while you can recuperate and care for yourself. You may begin to feel guilty for thinking of yourself at a time like this, but it is normal to be concerned with your own physical condition and there is no better time for you than now, when the medical staff is relieving you temporarily. As your physical and emotional strength increase, you may be able to arrange to see and touch your baby several times each day even if he or she is in the special care unit.

When you do come home from the hospital, it may be difficult for you to accept your postoperative condition. The physical limitations may increase your feelings of helplessness. You may feel guilty for tiring easily and having to be dependent on others for the care of your baby, your house, your other children, and yourself.

“I felt like such a burden! I couldn't bear lying around and letting everyone do things for me. It's not my style. But I had no choice. Whenever I tried to do things for myself, and I bent too low or moved too quickly or did too much, I'd have to stop. That's when I'd cry from frustration.”

“I didn't feel like a new mother, I felt like an old woman, an invalid. It took some of the joy away but when I accepted it - the fact that I was recuperating from surgery - I felt myself getting stronger and happier each day.”

If yours was a vertical incision, you may feel very upset about the scar on your abdomen. You may believe that it is ugly and that you will never again be able to wear a bikini or undress in front of anyone. You may worry that your mate will not be able to adjust to it and might even be turned off by it.

Many people are left with scars on their bodies, not just as a result of childbirth. Each individual must find a way to accept what has happened. You will need to adjust to your new body image, which includes the Cesarean scar. This is now a part of you, just like your nose, your ears, or any other permanent feature of your body. If you accept it as a part of who you are, if you walk proudly, wear clothing with assurance, and do not try to cover or hide the scar, others will accept it. If you exhibit no signs of shame or embarrassment, your cool and confident manner will set people at ease. If you're not upset about the scar, if you aren't embarrassed or ashamed of it - why should they be upset, embarrassed, or ashamed for you?

Because you are so aware of your scar, you may assume that it has monumental significance to anyone who sees it. Your concept of its magnitude and visibility may be out of all proportion to reality. Try to see yourself not as a woman with a scar on her abdomen, but as a woman, who happens to have a scar on her abdomen. Where you place the accent in your own head really makes the difference.

A prime source for emotional support during the early adjustment period are other mothers who have had the Cesarean experience. What a relief you will feel when you know that all your fears, discomforts, complaints, and crying jags are thoroughly understood and sympathized with because they have had them too. Contact your childbirth educator, or a childbirth education group and ask to speak with other Cesarean parents on a one-to-one basis or in a rap group setting.

Sharing and exchanging feelings between you and your mate is also very important. It usually helps each of you to know what the other was feeling at the time and is feeling now about the Cesarean experience. Such open discussion will also help both of you to know what aspects of your hospital experience you would not want repeated the next time.

Believe how important it is for you, more than for other new mothers, to get lots of rest to aid your recuperation. If you do not rest, if you try to do everything yourself the first week or two at home, you are likely to become extremely exhausted and find yourself frustrated at ,not being able to get anything done. The blues may result. On the other hand, if you care for yourself during the first weeks, you'll recoup strength to be better able to take on your responsibilities as you become stronger. The more help you ask for and take, the sooner you will be able to do the things you'd like and resume normal activities.

The Cesarean Father

As the father of a baby about to be born by Cesarean, you may feel confident in and reassured by the physician who is about to begin the surgery; relieved that your mate is in good hands and that the best possible medical care is being given to her and your baby. On the other hand, as confident as you may be in the medical staff, you may feel extremely anxious during the time you are waiting for the surgery to be completed - especially if you had been together with your mate earlier in labor and had planned to be with her for the birth of your baby but are now excluded. Totally cut off, you may feel frustrated, isolated, and utterly helpless for perhaps an hour and a half. The longer the lack of contact with anyone who knows what's going on, the more your fears may build: what's taking so long, what's wrong, is she all right, is the baby all right, why isn't someone telling me anything? All sorts of frightening images and thoughts may plague you while you wait. And wait. And wait and wait in the lounge, lobby, fathers' waiting room, hallway, or wherever hospital policy designates you will wait. Each time you hear a doctor being paged on the P.A. system, you might imagine that he's being called to the aid of your loved one and baby. Each half hour that passes may further convince you that something must have gone wrong. Hours may pass without any information. When the doctor finally tells you that you have a baby girl or boy, you may find yourself waiting for the rest of the news, almost sure that it can't be good. Not being there to know what is happening can cause your mind to conjure up the most frightening possibilities. Being separated from the mother and the new baby, in some cases for hours after delivery, can increase your anxieties. Your initial joy at the news that mother and baby are doing fine can be minimized by separation.

After hearing that all is well and the danger is over, you may discover other feelings rising within you. One may be of anger for being shunted aside, excluded as though you were a complete stranger who has nothing at all to do with the woman involved. You might be thinking, “How dare they do this to me, the father!” Feeling helpless at not being able to offer comfort, and then feeling guilty for not being there when she needed you, may cause you great unhappiness.

You may also feel great disappointment for not being permitted to witness the birth of your own child. Perhaps after learning in childbirth education classes how to coach your mate through labor and delivery, looking forward to sharing the birth experience, and priming for going all the way into the delivery room - it is difficult to accept the shock of being barred from the delivery room door.

You may feel resentment for having been “cheated” out of witnessing the miracle of birth, denied the thrill of being present at such a momentous event. These feelings may be followed by those of guilt for having thought them in the first place: “How could I be so resentful? I should be happy that my wife and baby are okay. So what if I wasn't there? That’s not the main thing.”

But still there are nagging jealousies of other fathers who are flying high on excitement from being present at the birth of their children.

Although there are many fathers who have no desire at all to be present during delivery, there is a great deal of misunderstanding surrounding the reasons why any father does. Simply stated, his are the very same reasons a Lamaze-trained father wants to be present at his baby's birth: he wants to be emotionally supportive to his mate during the stress of the birth process and he wants to share with her the miraculous moment of their child's entrance into the world. He is not interested in, nor is he invited or expected to observe, the surgery. Seated on a stool alongside his mate's head, his visibility can be limited by the same chest-screen which limits hers.


The reasons given by hospital personnel and obstetricians for not permitting fathers into Cesarean delivery rooms echo the very same reasons given twenty years ago to keep fathers out of vaginal delivery rooms: there's no room for him, he might get in the way, he might faint, he might introduce infection, he might misinterpret procedures and institute a malpractice suit. These objections were overridden as a result of good experience over the years with no fathers getting in the way, fainting, causing infection, or suing doctors. Similarly, only time and experience will override the objections to having Cesarean fathers present. An oft-repeated supposition by opposing obstetricians is: “What if there is an emergency? How do we tell a father to leave and what if he refuses at a moment of life-and-death decision making?” This supposition was also raised years ago with regard to an emergency situation during a vaginal delivery. Fathers who are welcomed into the delivery room - vaginal or Cesarean - are told that they will be expected to leave if an emergency arises. This has not resulted in any problems, as evidenced by the fact that more and more hospitals are opening their Cesarean delivery room doors to fathers; several pioneering hospitals have been doing this for about seven years with no bad effects on anyone.

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